A recent study on the impact of Massachusetts health care reform on women’s health reveals how important access to convenient and affordable health care can be for women and their families. On August 26, Kelly Blanchard and Amanda Dennis summarized the study’s findings for the Ms. Magazine blog. They wrote that not only did health care reform improve the physical health of Massachusetts citizens, but their emotional and psychological health as well. Blanchard and Dennis reported that “Women in the focus groups in our study explained that access to health insurance was about more than having an insurance card. They said that after reform they felt empowered because they could seek out both preventive care and general reproductive health care.”
For those who already received insurance through their employer, Massachusetts health care reform did not change their plan. However, reform made it so the previously uninsured Massachusetts residents are now covered through either the expansion of the existing subsidized state health care programs or through new programs which were created. Additionally, the state now enforces an insurance mandate by requiring taxpayers to file proof of health insurance with their annual tax forms. These reforms have had numerous benefits for Massachusetts women.
Increased access to contraception is one significant way that health reform in Massachusetts improved the lives of women and their families. After health reform, most women in the focus groups “reported that they had ‘wicked easy’ access to their preferred method.” Some women said that they only began using the contraceptive pill for the first time after health care reform “because they ‘could afford it.’ One woman said, ‘I know a big factor for a lot of my friends—like the pill is just too expensive so they forego and they rely on other questionable methods and I think health care reform will help bring unplanned pregnancies and stuff like that down.’” We have written before about the importance of access to affordable family planning services which improves the health of women and their families while lowering health care costs associated with unintended pregnancy.
The study also revealed pitfalls that states should avoid when implementing the Affordable Health Care Act. Blanchard and Dennis emphasize that
Findings from the study… highlight the critical need to pay attention to the architecture of reform. For example, providers struggled with new billing rules and practices with the new subsidized health plans, and women experienced challenges enrolling in and maintaining coverage through these plans and understanding the benefits of insurance and how to fill prescriptions. Additionally, some women, including minors and some immigrant women, are largely not eligible for benefits under reform, and had trouble getting needed care.
To read more about the study on Massachusetts health care reform and its positive effects for women and their families, click here.
Since we last blogged about Crisis Pregnancy Centers, a new development has increased the threat they pose to women’s access to comprehensive reproductive health care. A new initiative by several pro-life groups aims to fund CPCs’ conversion to medical clinics, staffing them with doctors and nurses and expanding their health care offerings – while they continue to oppose abortion and contraception and block or impede women’s access to those alternatives (we blogged about the misinformation provided by CPCs here).
AlterNet has the full story in their August 18 article, “The Anti-Choice Plan to Lure Women to Christian Pregnancy Centers.” Author Tana Ganeva calls our attention to the efforts of Focus on the Family and the National Institute of Family and Life Advocates to make CPCs even more important players in women’s health care. NIFLA’s Life Choice project, established in 1998, gives CPCs legal advice as they transition to medical clinic status, and trains nurses and doctors to work in the newly created clinics. Since 2004, Focus on the Family has been funding the conversion of particularly high-impact CPCs into medical clinics. CPCs have long offered biased counseling and limited prenatal services to pregnant women, as well as post-natal services in some cases. As medical clinics, with doctors, nurses, ultrasounds, pregnancy tests, and perhaps even PAP smears, CPCs become more attractive to women who need these services and do not necessarily know about the ideology driving the centers.
This is particularly disturbing in light of the increasingly precarious situation of Planned Parenthood, on whose clinics many women have long relied for their health care. As many conservative governors have slashed funding for Planned Parenthood while funneling funds to CPCs through programs that support abstinence-only education, women are beginning to see their options constrict. The New York Times featured Texas as an example of this trend in an article last month.
A CPC turned licensed medical clinic, with a doctor and nurses, may soon be the most accessible pregnancy care option for many women, who could walk in the door not knowing they have entered an explicitly anti-abortion zone where they may not be presented with all of their options.
Ovarian cancer is the fifth most common cancer in women but “causes more deaths than any other type female reproductive cancer.” The high fatality rate of ovarian cancer is partially due to the fact that it is difficult to diagnose. Ovarian cancer “is usually quite advanced by the time diagnosis is made.” Unfortunately, a recent study revealed that doctors often neglect to refer women at a high risk for developing the disease to an ovarian cancer screening. Indeed, 60% of physicians surveyed would not recommend testing for a woman at high risk for developing ovarian cancer.
While many high-risk women are not screened for ovarian cancer, far too many women at only an average risk of developing ovarian cancer are screened. Additionally, the study found that 30% of doctors in the study would refer a woman with an average risk of developing ovarian cancer to screening. The U.S. Preventive Services Task Force (USPSTF) “a federally-supported expert panel, advises against routine counseling and testing for women who don’t have suspicious cases of cancer in their family, such as two close relatives with breast cancer, one of whom got it before age 50.” It is unwise to submit a woman at only an average risk of developing ovarian cancer to testing because the tests themselves may be harmful to her health. Also, unnecessary testing will put a strain on the healthcare system.
Jacqueline Miller at the U.S. Centers for Disease Control and Prevention, who worked on the study, told the Los Angeles Times that only 1 in 300 women carry the gene mutations which put one at an increased risk for developing breast and ovarian cancers. Since the mutations are so rare, if women at average risk for developing ovarian cancer were routinely screened, “‘you would be over-testing a lot of women, spending a lot of resources and a lot of money.’” She added that it is possible that over-testing would cause “some false alarms as well, exposing women to unnecessary treatment and other harms…‘For a lot of women, just going through the test creates a lot of anxiety,’ she said.”
Miller stated that “The most important lesson from the new findings are to make sure that women at high risk are identified so they can get the right counseling.” However, she advises “that women should never agree to get tested without knowing the reasons. ‘You should have that conversation with your provider: why do you feel I’m at high risk? If a physician tells you you should get genetic counseling, you should understand why.’” To learn more about ovarian cancer and the research that is being done to combat it, click here.
Last week, a Ms. Magazine blog post brought to our attention an important California initiative that would protect women’s health insurance during pregnancy. Unlike most states, California offers Pregnancy Leave up to four months for eligible women and Paid Family Leave, which provides employees with a portion of their income during their leave from work. However, these laws do not require employers to keep their employees on a health insurance plan during their pregnancy leave. The California Work and Family Coalition is working to fill this gap in the law. SB 299 (pdf) would make it illegal for an employer to remove a pregnant woman from her health plan during her leave, assuming that leave is no longer than four months out of a year.
As Ms. points out, women need their health insurance more than ever during pregnancy: “Statistics show that approximately 13 percent of women will have a complication from pregnancy requiring them to be hospitalized before delivery. Twenty percent of pregnant women spend a minimum of one week on bedrest during the course of their pregnancy.”
The fact that most California women can take a leave of absence from work during pregnancy without fear of losing their jobs is an important victory for them and their families. The next step is to ensure that they can take leave without fear of losing their health care.